Validation of the six-and-twelve criteria among patients with hepatocellular carcinoma and performance score 1 receiving transarterial chemoembolization  

作　　者：Zhe-Xuan Wang Jing Li En-Xin Wang Dong-Dong Xia Wei Bai Qiu-He Wang Jie Yuan Xiao-Mei Li Jing Niu Zhan-Xin Yin Jie-Lai Xia Dai-Ming Fan Guo-Hong Han 

机构地区：[1]Department of Liver Disease and Digestive Interventional Radiology,National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases,Fourth Military Medical University,Xi’an 710032,Shaanxi Province,China [2]Department of Health Statistics,Fourth Military Medical University,Xi’an 710032,Shaanxi Province,China

出　　处：《World Journal of Gastroenterology》2020年第15期1805-1819,共15页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Transarterial chemoembolization(TACE)is recommended for patients with intermediate hepatocellular carcinoma(HCC)according to treatment guidelines.However,a large number of patients with advanced HCC also receive TACE in clinical practice,especially for those with liver-confined HCC and Eastern Cooperative Oncology Group score(ECOG)1.In view of previous studies,such patients have different prognoses from advanced HCC patients with macrovascular invasion or extrahepatic spread;therefore,patients with ECOG 1 alone might be classified into the intermediate stage and benefit from TACE treatment,but a study particularly focusing on such patients and exploring the effectiveness of TACE therapy is lacking.AIM To investigate treatment outcomes of TACE in HCC patients with ECOG 1 alone and propose a specific prognostic model.METHODS Patients from 24 Chinese tertiary hospitals were selected in this nationwide multicenter observational study from January 2010 to May 2016.Overall survival(OS)was estimated using Kaplan–Meier curves and compared by the log-rank test.Multivariate Cox regression was used to develop the potential prognostic models.The discriminatory ability of the models was compared and validated in various patient subgroups.The individual survival prediction for six-and-twelve(6&12)criteria,defined as the algebraic sum of tumor size(cm)and tumor number,was illustrated by contour plot of 3-year survival probability and nomogram.RESULTS A total of 792 eligible patients were included.During follow-up,median OS reached 18.9 mo[95%confidence interval(CI):16.9-21.0].Three independent multivariate analyses demonstrated that tumor size,tumor number,α-fetoprotein level,albumin–bilirubin grade and total bilirubin were prognostic factors of OS(P<0.05).The previously proposed 6&12 criteria was comparable or even better than currently proposed with the highest predictive ability.In addition,the 6&12 criteria was correlated with OS in various subgroups of patients.The patients were stratified into three strata

关 键 词：Transarterial CHEMOEMBOLIZATION HEPATOCELLULAR carcinoma Overall survival Predictive factors PROGNOSTIC model Risk STRATIFICATION 

分 类 号：R735.7[医药卫生—肿瘤]